I took the old Opanas, and was very happy with them. Nothing had worked SO well and with so few side effects! When they reformulated, I thought nothing of it, but the new Opana ERs are awful. The efficacy is greatly reduced. and they give me terrible stomach pain, like a hot coal in my stomach. Switched to the generic (oxymorphone) and it's like having the old Opana back!... but my insurer won't cover it. They want to switch me to fentanyl patch instead, even though it's not recommended for anyone of my low weight, particularly not as I'm underweight to boot. I'm terrified of fentanyl, and not looking forward to the withdrawals changing to it will entail, plus those which occur every time you change the patch (it has to build up in your skin for 72 hours to start working). I can't afford not to be functional for days at a time as the level of medication in my system yoyos.It seems crazy, to take someone off something that works so well for them, to put them on something that could be dangerous for them in particular (and is dangerous period, due to its extremely high potency). So, those of you who have experienced any part of this:

Have you successfully appealed your insurer's decisions, to get what works for you? (Whatever that may be?)Have you been switched to fentanyl? If so, how do you deal with the lack of pain medication when the patch is changed? I already have to take breakthrough pain medication, and have a feeling they'll tell me to use that, but I already am. Most people seem to have had their dose raised when the reformulated tablets failed to work as well, but my doctor doesn't want to do that, and I'd rather take the same low dose, but of the generic.

Tell me what your experience has been, either with your insurer, or with the medications, especially if you were switched. I will probably have to try the fentanyl, so I need to learn how to deal with it.

Responses (2)

You can try to appeal to your insurance company but you will need your Drs help. Call them to find out how to appeal and what information they need to authorize it. If your Dr feels that Fentanyl is unsafe for you at your weight, then that might be something he can document to the insurer. Fentanyl is no more dangerous than Opana ER. All strong opioids carry the same risks-the potency of Fentanyl is high but you dont take as much either, micrograms per hour in the patch as opposed to milligrams in the Opana pill twice a day . If your Dr does your conversion properly, you shouldnt have much in the way of withdrawals going from one drug to the other. I went from Oxycontin to Fentanyl with no problem. Fentanyl patches were a wonderful medicine but I developed an allergy to the adhesive and I also had trouble keeping the patches on. Many Drs (and insurers) like Fentanyl because it is a closed system and when used properly it can provide pain control for days. It is odd that your insurer wont let you have generic oxymorphone. The only reason I can think of is due to it being less "tamper resistant" and more than likely they are going to do the same to oxymorphone ER and they did to oxycodone ER and stop generic production because it doesnt have the "tamper resistant" qualities that they made the original formulas change to. There is a major stink going on from the manufacturers of Opana ER and the generics manufacturers about this and the same occurred when Oxycontin switched formulas so your reprieve is likely to be brief because it looks likely that generic oxymorphone ER will be withdrawn from the market if the manufacturers get their way.

I went from the old Opana to Fentanyl on my own initiative and then had narcolepsy as a side-effect to the patches and then went back to Opana before they reformulated and had a similar result with the new formulation, stomach upset and at least a perceived lack of strength from the old octagonal version. I've recently moved to the generic Oxymorphone ER and some IR for breakthrough pain and find it much better. The only pain med besides the patches that brings my pain level to zero but without the side-effects of the patches. I had to get a pre-auth from my Dr. before I got insurance to cover it but not for the same reasons as you I think. I did find that the patches do start to work within hours of putting them on so I wouldn't worry about withdrawal although when I stopped the patches I did suffer some withdrawal before starting Opana again but only because I couldn't live with the side effects and stopped before going to the doc. They were not as strong as withdrawals I had from the Opana when I had a lapse in insurance coverage and had to go without for a couple days before getting the money to pay for the Opana out of pocket (roughly $800). I hope that helps but getting your doctor to write your insurance is a very good idea.